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1 https://wordpress.org/?v=5.4.1Covid-19 pandemic disrupts clinical trials in Alzheimer’s diseasehttps://dementiatoday.net/covid-19-pandemic-disrupts-clinical-trials-in-alzheimers-disease/
Thu, 14 May 2020 17:37:39 +0000https://dementiatoday.net/?p=5341The pharmaceutical industry has been as affected as any other industry by the Covid-19 pandemic; most countries’ sites have put clinical trial studies on hold, due to the inability to have dosing and in-person clinic visits for treatment and prevention […]

]]>The pharmaceutical industry has been as affected as any other industry by the Covid-19 pandemic; most countries’ sites have put clinical trial studies on hold, due to the inability to have dosing and in-person clinic visits for treatment and prevention trials, and pharmaceutical companies are shifting their overall priorities away from some current indications, such as those focusing on Alzheimer’s disease, toward Covid-19, according to GlobalData, a leading data and analytics company.

In the Alzheimer’s pipeline, 19 drugs are in Phase III, 37 are in Phase II, and 38 are in Phase I of development. Targeting Aβ is the favored mechanism of action for disease-modifying therapies (DMTs) in the mid- and late-stage trials; currently, six of these drugs are in Phase III, including Roche’s gantenerumab, Biogen’s aducanumab, and Eisai’s BAN-2401, and six DMTs are in Phase II including Eli Lilly’s donanemab and Alzheon’s ALZ-801.

There are currently no reports about how susceptible pregnant women may be to COVID-19 or about transmission of the virus through breast milk.

What are the symptoms of COVID-19?

Common symptoms of COVID-19 begin two to 14 days after exposure. They include fever, tiredness, and dry cough. Other symptoms include sputum production, shortness of breath, sore throat, headache, myalgia (muscle pain) or arthralgia (joint pain), chills, vomiting, and nasal congestion. Less frequent symptoms include diarrhea, hemoptysis (coughing up blood from the respiratory tract), and conjunctival congestion.

Most of these symptoms are usually mild, and about 80% of people who get the virus will typically recover without needing any special treatment. However, about 1 in 6 patients become seriously ill and develop breathing difficulties.

Not all pharmaceutical companies have been responding in the same way to the Covid-19 pandemic as Roche, for example, continues both enrolment and dosing in the company’s Alzheimer’s late-stage trial of gantenerumab. On the other hand, Eli Lilly, which has several Alzheimer’s drugs in the pipeline—including solanezumab, in a Phase III trial for older individuals who may be at risk for memory loss—is halting enrollment and postponing new trials while continuing dosing in ongoing trials.

Axsome Therapeutics concluded patient participation early in the Phase III study of its lead drug candidate, AXS-05, in patients with Alzheimer’s agitation. The company already completed randomising hundreds of patients for both the AXS-05 and placebo arms, and more than 90% of patients enrolled had completed the five weeks of the study. The decision to accelerate the completion of this trial was made using the FDA’s Guidance on Conduct of Clinical Trials of Medical Products during Covid-19 Pandemic, which discusses the potential impact of the pandemic on the conduct of clinical trials and on the resulting need to ensure the safety of trial participants. With the acceleration of the trial, top-line results are expected in June 2020.

Conversely, Biogen was expected to complete FDA filing for its recombinant human monoclonal antibody (mAb) aducanumab in early 2020, but due to the coronavirus that affected several members of senior management, the regulatory filing and review is expected to take more time than originally estimated. Biogen also launched a new trial called EMBARK for people who were enrolled in Phase III trials of aducanumab at the Advanced Memory Centre. Due to Covid-19, the launch of the trial in other sites will not happen at least until June 2020.

With the current situation of lockdown in most of the countries, people ages65 and older are not able to participate in clinical trials. However, physicians are staying in contact with their participants and carers through remote technology. The research can still continue as researchers can collect and analyze some clinical and cognitive data. The disruption of important clinical research by the Covid-19 pandemic is linked also to the particular vulnerability of the older adults, the most targeted subjects by Covid-19. The number of deaths in the elderly population worldwide has already reached significant numbers, and participants of Alzheimer’s trials dying from coronavirus can significantly affect the outcome of Alzheimer’s studies.

To mitigate the disruption of Alzheimer’s clinical trials due to Covid-19, new interventions need to be implemented due to the inability to leave home. With the new technologies available, researchers and physicians can remotely screen potential participants rather than conducting in-person visits and support their families and carers during these difficult and uncertain times.

]]>Coronavirus: Information for people affected by dementiahttps://dementiatoday.net/coronavirus-information-for-people-affected-by-dementia/
Thu, 14 May 2020 17:35:17 +0000https://dementiatoday.net/?p=5337During the coronavirus pandemic we have advice and practical tips for people living with dementia and those supporting them – either in the same household or from a distance. We will update this information regularly, including details about how Alzheimer’s […]

]]>During the coronavirus pandemic we have advice and practical tips for people living with dementia and those supporting them – either in the same household or from a distance.

We will update this information regularly, including details about how Alzheimer’s Society can help. This will provide support to help you get through this difficult time, so do come back to see what’s available.

About coronavirus

Coronavirus causes a new illness (COVID-19) that mainly affects your lungs and airways.

Symptoms in most people will be mild – a high temperature and persistent cough. Some people will also have difficulty with breathing (shortness of breath).

A few people with COVID-19 will get severe symptoms and need medical attention. Older people and those with a long-term health condition (for example, lung disease, heart failure, diabetes) or a weakened immune system (for example, because of HIV or chemotherapy) are more likely to get worse symptoms. These are people who are offered the regular flu jab every year in the autumn.

The higher-risk groups for severe coronavirus illness include almost everyone with dementia, and many older family carers.

What is COVID-19?

COVID-19, short for coronavirus disease 2019, is an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is a newly identified pathogen that has not previously been seen in humans and is highly contagious. Though it belongs to the same category of viruses as SARS coronavirus (SARS-CoV) and influenza viruses, SARS-CoV-2 is a different strain with its own characteristics.

COVID-19 was first reported in Wuhan, China, in December 2019, and the outbreak has spread quickly across the world, prompting the World Health Organization (WHO) to declare COVID-19 a pandemic.

Advice for everyone

We must do all we can to fight coronavirus. It’s spread easily between people and not everyone with coronavirus infection has obvious symptoms.

To stop us catching or spreading the virus, the law now says that everyone should stay at home as much as possible.

The rules about this are different in Wales, Northern Ireland and England so check the guidance about going out for the area where you live. For all regions you are allowed to leave home for:

shopping – for things like food and medicine

exercising outdoors

any medical need – including to provide care, to help a vulnerable person or to escape risk of harm

going to work – where you cannot work from home.

Even when doing these, we must always keep two metres (three steps) away from anyone outside the household. Use public transport only if your journey is essential. A face cover is recommended on public transport and some shops, where it’s harder to keep two metres away from people.

These rules apply to everyone. They should be followed particularly carefully by people with dementia and those living with them. This is because people with dementia and older people in general are at higher risk of severe illness if they catch coronavirus.

]]>Caring for Someone with Alzheimer’s During the COVID-19 Outbreak: 5 Tipshttps://dementiatoday.net/caring-for-someone-with-alzheimers-during-the-covid-19-outbreak-5-tips/
Thu, 14 May 2020 17:30:09 +0000https://dementiatoday.net/?p=5335Demonstrating how to wash your hands for a loved one with Alzheimer’s disease can help ensure they practice safe hygiene. The Alzheimer’s Association recommends planning for other caregivers to step up in case you become ill with COVID-19. Talk to […]

Demonstrating how to wash your hands for a loved one with Alzheimer’s disease can help ensure they practice safe hygiene.

The Alzheimer’s Association recommends planning for other caregivers to step up in case you become ill with COVID-19.

Talk to your loved one about the pandemic in terms they understand.

Practice self-care so you’re able to manage stress and anxiety and function as a caregiver.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub and follow our live updates page for the most recent information on the COVID-19 outbreak.

Caring for a loved one with Alzheimer’s disease during the pandemic brings about challenges, especially given the social distancing measures put in place.

“There’s no perfect solution for anybody these days, but if you are a caregiver for someone with dementia in your home or in a facility, you are facing uncharted territory,” Tom Meuser, PhD, director of the Center for Excellence in Aging & Health at the University of New England, told Healthline.

Experts offer the following 5 simple tips on how to navigate the complex and quickly changing environment.

1. Focus on safe hygiene

Because those with Alzheimer’s and other types of dementia may forget to wash their hands, Beth Kallmyer, vice president of care and support at the Alzheimer’s Association, encourages caregivers to be extra vigilant in helping individuals practice safe hygiene.

“In some situations, caregivers [can] help them do that either by setting up a schedule to do hand washing on a regular basis or having signs in the bathroom or by the kitchen sink to remind them to wash their hands for 20 seconds,” Kallmyer told Healthline.

Repetition can help encourage behavior changes in those with moderate dementia.

“Physical demonstration of the behavior can be helpful where you guide the person by modeling good hygiene yourself,” Meuser said.

However, if your loved one isn’t leaving the home and isn’t exposed to other people, he says to consider their risk.

“On one hand you can go crazy about educating your loved one on hygiene and what’s going on to the point where you may cause them unnecessary stress because they’re not capable of learning and remembering. Do the best you can, given the situation,” he said.

2. Plan for gaps in caregiving

As adult day care programs shut down and health services become less available due to public health containment strategies for COVID-19, families should anticipate that less help and support may be available for their loved one.

“In the event any facility does close… our clients can be transferred to a similar level of care,” Barlowe told Healthline.

If you care for a loved one in your home, Kallmyer said to think about who will step in if you become ill.

“This is critical for family caregivers to think about now before there is a problem. If you do have to make a different decision about who’s providing care, it’s really hard to do that in the middle of a crisis. If you are a spousal caregiver or family caregiver… we want families to have hard discussions and come together to figure out how they are going to fill the gap if someone gets sick,” she said.

Meuser said reach out to family, friends, and neighbors to assess the potential support you have.

“You might assume that someone in your close network wouldn’t help, but you don’t know until you ask. Have a little humility and allow yourself to ask, which is hard for some caregivers, especially if you’ve been burned in the past,” he said.

Avoid judging yourself by the standards you held as a caregiver a few months ago, he added.

“Recognize that the playing field is different and you’re going to do the best thing that you can as a caregiver,” said Meuser.

If you’re forced to bring a loved one home from a facility, Barlowe said that aging life care professionals can help with the transition and put you in touch with local resources, such as durable medical supply companies and home health companies, as well as explain the regulations of these industries.

“The loved one may need to be quarantined for a period of time to ensure they are not bringing the virus into the home and/or infecting their caregiver(s). If this is impossible due to dementia or physical complications requiring regular contact, attempt to limit the amount of caregivers caring for the person. I would even consider a ‘live-in’ caregiver if continuous care is needed to avoid several caregivers coming in and out to do shift type work,” Barlowe said.

You can also call the association’s free 24/7 Helpline at 800-272-3900.

When it comes to managing regular doctor’s appointments, Barlowe recommends contacting the doctor’s office and discussing the risks of having to transport your loved one to the office.

Most offices are postponing nonessential appointments and scheduling telehealth sessions when possible.

“This pandemic is extremely challenging for someone with Alzheimer’s disease as they cannot grasp the magnitude of the situation. I recommend for their caregiver’s safety, as well as their safety, that they remain at home and avoid medical appointments if at all possible until the situation is safer,” Barlowe said.

3. Ask care facilities about communication policies

In order to protect the health of their residents, many facilities are restricting access to outside visitors.

“We get lots of calls of family members who are distressed because they typically go to a residence to visit a person they are caring for on a regular basis and it’s been really hard not to be able to do that,” Kallmyer said.

She says to call and ask how best to coordinate calls with your loved one.

Barlowe suggests identifying one staff member at the facility that you have a relationship with and asking them to be your point of contact.

“Attempt to get that employee’s cell number and communicate directly via text/video calls with them to see your loved one,” she said. “Book the next appointment before you get off the phone with them so you don’t have to call to schedule each time.”

Purchasing a tablet and loading it with contact information for family members and friends, photos, social media sites, and games is a great way to keep your loved one connected.

“Make facility staff aware of how easy you have made it for them to help your loved one engage without their constant assistance, they may just need to help turn it on,” Barlowe said.

Dan Odomirok, technology expert and head of IT at the digital platform Fello, says to find creative ways to engage your loved one with technology based on their cognitive abilities.

“Video chatting is one thing, but be sure to introduce your loved one to group video chats that include other friends and family. Host a virtual dinner, commemorate someone’s birthday, graduation, or anniversary. Challenge them to an online game like Words with Friends or Mahjong. Challenge them on Instagram to create a story of the average day,” Odomirok told Healthline.

Rather than news, he said to try to get them to watch something more positive by streaming a show simultaneously so you can watch it together.

He adds that it’s particularly important to turn to technology to connect with older adults who may be feeling lonelier than ever.

“Seniors living in assisted-care and nursing homes have loss of critical social activities such as off-site trips, game nights, communal dining, and fitness classes. Confined to their rooms or apartments, these seniors are left with little to no social contact at all,” said Odomirok.

“Technology offers several ways for the isolated to still stay connected with the outside world,” he said.

4. Explain the pandemic in relatable terms

Talk to your loved one about the pandemic in a way they can understand.

“Depending on where they are in the course of the disease, put it in a context that they can understand and don’t overexplain if they are not able to grasp it,” Kallmyer said.

Stay calm and reassuring, too, she adds.

She recommends saying something like, “We have to stay inside because that’s most safe for us, but we’ll do it together. I’ll be with you and we’ll be okay.”

Meuser agreed, noting that you most likely know your loved one’s emotional and cognitive state best.

“You know if small things set that person off and cause great distress or if they are calm and generally agreeable and don’t get riled up about normal life. You have to weigh whether it’s worth sharing much detail of anything if it might make things harder,” he said.

Because memories fade in reverse with Alzheimer’s, Meuser said a person with moderate dementia may still remember their youth clearly. Drawing on early memories to explain and contextualize the present may help explain the pandemic.

“WW2 brought rationing, shortages, doing without, etc. It was a time of national unity and shared purpose. While today is not exactly like this, there are parallels,” he said.

“Social distancing is something most Americans agree with and accept readily for the common good. If you were born in the 30s, you still remember what it was like in WW2 from your childhood or parents talking about it, so appealing to those memories of that time may be one way to frame the current crisis in a way the person can understand,” Meuser said.

5. Practice self-care

Because many people are feeling anxious, Kallmyer said it’s important for caregivers to practice self-care.

“We don’t know how long this is going to go on or what’s going to happen, and one of the things we are telling family caregivers is to be aware of their own anxiety and stress level because the person with dementia can pick up on that, especially if they can’t really understand the context of what’s going on,” she said.

The Alzheimer’s Association suggests the following ways to reduce anxiety about the pandemic:

Pay attention to your own level of stress.

Stay present by engaging in activities in your home with the person you’re caring for, such as folding clothes or cooking.

Stay off social media if it makes you anxious.

Keep news to a minimum.

Meuser recommends using online capabilities, such as Zoom, Google Hangouts, or Skype, and the telephone for respite during social distancing.

“Engage other family members with your older adult if they are willing to sit by the computer and listen to a story or engage in conversation or a simple game. If your siblings live halfway across the country, say, ‘I need you to sit and talk to dad for 30 minutes,’ so you can get rest or do what you need to do,” he said.

If your loved one is in a facility, Meuser says self-care is still important during the pandemic.

“Caring for yourself now is actually caring for your loved one with dementia in the long-term because you want to be in a good place emotionally and physically when you can reinitiate your full care responsibilities,” he said.

###

Cathy Cassata is a freelance writer who specializes in stories about health, mental health, and human behavior.

]]>COVID-19: Advice for caring for people with Alzheimer’s disease, mild cognitive impairmenthttps://dementiatoday.net/covid-19-advice-for-caring-for-people-with-alzheimers-disease-mild-cognitive-impairment/
Thu, 14 May 2020 17:25:02 +0000https://dementiatoday.net/?p=5330With the COVID-19 pandemic at the forefront of daily life, how much information should you share with a loved one who has Alzheimer’s disease, dementia or mild cognitive impairment? And how do you explain the necessary precautions and social distancing […]

]]>With the COVID-19 pandemic at the forefront of daily life, how much information should you share with a loved one who has Alzheimer’s disease, dementia or mild cognitive impairment? And how do you explain the necessary precautions and social distancing requirements?

“If someone is processing relatively well ― they have, perhaps, mild cognitive impairment, and are able to have good conversations and partake in the world ― there’s no problem with having just a general discussion about everything and reminding them about what they need to do, such as washing their hands and everything that comes with good infection control,” says Dr. Sirven.

For people who have dementia or more severe issues, such as Alzheimer’s disease, and may not be able to process information, it’s best to avoid discussions about COVID-19.

Since social distancing and isolation rules may make it more challenging to be with loved ones, Dr. Beth Rush, a Mayo Clinic neuropsychologist, says they may be agitated or anxious.

“It’s important to validate their feelings and then offer a suggestion,” Dr. Rush says. “For instance, you might say: ‘I’m sorry I can’t visit today and I know that’s disappointing. But what if we set up a daily call at 8 a.m. to chat over coffee?'”

Also, since behavioral outbursts are common in patients with neurodegenerative disorders, now would be the time to develop a plan regarding extra support or when to call 911.

“These patients can become confused or become very anxious or very nervous with any change in the home environment,” says Dr. Sirven. “So it’s important to keep the environment calm and have a plan regarding potential mediations or strategies to help alleviate things should the patient or situation become too difficult to manage.”

Dr. Rush adds that caregivers should be honest with how they are feeling and not hesitate to ask for help if they feel overwhelmed.

“Caregiving can be a difficult task on a normal day. At a time when people are experiencing heightened stress and anxiety as well as loss of normalcy, it’s important to do a personal check-in with yourself and acknowledge what you need to be at your best for your loved one. That may mean grabbing a snack, journaling, going for a walk, even taking a nap,” she says.

]]>Coronavirus (COVID-19): Tips for Dementia Caregivershttps://dementiatoday.net/coronavirus-covid-19-tips-for-dementia-caregivers/
Thu, 14 May 2020 17:22:17 +0000https://dementiatoday.net/?p=5324Most likely, dementia does not increase risk for COVID-19, the respiratory illness caused by the new coronavirus, just like dementia does not increase risk for flu. However, dementia-related behaviors, increased age and common health conditions that often accompany dementia may […]

]]>Most likely, dementia does not increase risk for COVID-19, the respiratory illness caused by the new coronavirus, just like dementia does not increase risk for flu. However, dementia-related behaviors, increased age and common health conditions that often accompany dementia may increase risk.

For example, people with Alzheimer’s disease and all other dementia may forget to wash their hands or take other recommended precautions to prevent illness. In addition, diseases like COVID-19 and the flu may worsen cognitive impairment due to dementia.

Tips for dementia caregivers at home

Caregivers of individuals living with Alzheimer’s and all other dementia should follow guidelines from the Centers for Disease Control (CDC), and consider the following tips:

For people living with dementia, increased confusion is often the first symptom of any illness. If a person living with dementia shows rapidly increased confusion, contact your health care provider for advice. Unless the person is having difficulty breathing or a very high fever, it is recommended that you call your health care provider instead of going directly to an emergency room. Your doctor may be able to treat the person without a visit to the hospital.

People living with dementia may need extra and/or written reminders and support to remember important hygienic practices from one day to the next.

Consider placing signs in the bathroom and elsewhere to remind people with dementia to wash their hands with soap for 20 seconds.

Demonstrate thorough hand-washing.

Alcohol-based hand sanitizer with at least 60% alcohol can be a quick alternative to hand-washing if the person with dementia cannot get to a sink or wash his/her hands easily.

Ask your pharmacist or doctor about filling prescriptions for a greater number of days to reduce trips to the pharmacy.

Think ahead and make alternative plans for the person with dementia should adult day care, respite, etc. be modified or cancelled in response to COVID-19.

Think ahead and make alternative plans for care management if the primary caregiver should become sick.

Tips for supporting persons with dementia who receive home-based services

If you currently receive or plan to receive services from a paid health care professional in your home:

Contact the home health care provider and ask them to explain their protocols to reduce the spread of COVID-19.

Check the home health care professional’s temperature before they enter your home. Anyone with a temperature over 100.4° F should be excluded from providing care.

Ask the health care professional if they have been exposed to anyone who has tested positive and if so, do not allow them into your home.

Ensure that the health care professional washes their hands upon arrival and regularly throughout their time in your home.

Ask the health care professional to wear a mask.

Be aware that bringing anyone into your home increases the risk of spreading COVID-19, even if CDC guidance is followed.

Tips for supporting persons with dementia who live in long-term care or residential care settings

Check with the facility regarding their procedures for managing COVID-19 risk. Ensure they have your emergency contact information and the information of another family member or friend as a backup.

Do not visit your family member if you have any signs or symptoms of illness.

Depending on the situation in your local area, facilities may limit or not allow visitors. This is to protect the residents but it can be difficult if you are unable to see your family member.

If visitation is not allowed, ask the facility how you can have contact with your family member. Options include telephone calls, video chats or even emails to check in.

If your family member is unable to engage in calls or video chats, ask the facility how you can keep in touch with facility staff in order to get updates.

Considerations if your family member’s residential facility has an incidence of COVID-19

It is important to note that there are no simple answers and, at this time, there is no way to completely eliminate the risk of your family member being exposed to COVID-19. However, there are some questions to consider if you are faced with this situation. The answers to these questions can help you make the best decision for your family.

Keeping the person in the facility

Ask the facility about their quarantine procedures. What is your level of confidence that CDC guidelines are being followed?

How many people in the facility have been impacted by COVID-19? Are those affected staff, residents or both?

Is your family member able to follow social distancing procedures(with or without help)?

In some cases, the person may not be able to walk or move about on their own. This could help maintain social distancing.

Does the facility have and use personal protective equipment?

How many staff members interact with your family member on a regular basis? Is the facility able to limit the number of staff who work with your family member?

Is the facility adequately staffed to provide the level of care your family member requires?

Moving a person home

What level of care does the person need on a day-to-day basis? (For example, is the person able to bathe and dress him- or herself? Are they continent? Are they ambulatory or do they need assistance moving?)

Is your family able to provide the level of care needed?

While limiting the number of people who have contact with the individual is important, it is also important to assess the number of people needed to provide adequate care.

Does anyone in your family have COVID-19 currently?

Are there individuals in the home who work outside of the home? If so, the risk for exposure is increased.

If you or the person you are caring for have regular doctor’s appointments to manage dementia or other health conditions, call your health care provider to inquire about a telehealth appointment. As a result of the COVID-19
pandemic, Medicare has recently expanded telehealth benefits to allow seniors to access health care from the safety of their homes.

Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing or sneezing.

If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.

Always wash your hands with soap and water if your hands are visibly dirty.

Tips for supporting persons living with dementia who are in the hospital

While many hospitals are restricting or limiting visitors to help curb the spread of COVID-19 and protect patients and staff, there are still ways to support the person living with dementia during their hospitalization. CDC guidance allows care partners of persons with dementia to visit if they are essential to the person’s physical or emotional well-being.

If visiting in person:

Be sure to familiarize yourself with the safety requirements of the hospital beforehand.

Bring your own face mask and put it on before arriving at the facility.

Wash your hands regularly and avoid touching your face.

Limit your visit to the room of the person living with dementia. (Avoid going to other locations in the hospital.)

If you are unable to visit in person:

Communicate with the person through phone or video calls.

Give your contact information to the attending nurse and ask for it to be written on the white board in the person’s room. Find out what kind of communication will be possible and how you can expect to receive updates.

]]>Alzheimer’s Disease Dementiahttps://dementiatoday.net/alzheimers-and-dementia/
Sat, 09 May 2020 00:03:59 +0000http://www.dementiatoday1.net/?p=4705Alzheimer’s disease (AD) is the seventh leading cause of all deaths in the United States and is virtually tied with the sixth leading cause of death – diabetes. AD is the fifth leading cause of death in Americans aged 65 […]

]]> Alzheimer’s disease (AD) is the seventh leading cause of all deaths in the United States and is virtually tied with the sixth leading cause of death – diabetes. AD is the fifth leading cause of death in Americans aged 65 and older. Although other major causes of death have been on the decrease, deaths because of AD have been rising dramatically. Between 2000 and 2006, heart disease deaths decreased 11.1%, stroke deaths decreased 18.2%, and prostate cancer-related deaths decreased 8.7%, whereas deaths because of AD increased 46.1%.

Older African-Americans and Hispanics are more likely than older white Americans to have AD or other dementia. Current estimates are that African-Americans are about 2 times more likely, and Hispanics about 1.5 times more likely, than their white counterparts to have these conditions. However, the relationship of race and ethnicity to the development of AD and other dementias is complex and not fully understood.

In 2009, nearly 11 million family and other unpaid caregivers provided an estimated 12.5 billion hours of care to persons with AD and other dementias; this care is valued at nearly $144 billion. Medicare payments for services to beneficiaries aged 65 years and older with AD and other dementias are three times higher than for beneficiaries without these conditions. Total payments for 2010 for health care and long-term care services for people aged 65 and older with AD and other dementias are expected to be $172 billion (not including the contributions of unpaid caregivers).

An estimated 5.3 million Americans have AD; approximately 200,000 persons under age 65 with AD comprise the younger-onset AD population. Every 70 seconds, someone in America develops AD; by 2050 the time of every 70 seconds is expected to decrease to every 33 seconds. Over the coming decades, the baby boom population is projected to add 10 million people to these numbers. In 2050, the incidence of AD is expected to approach nearly a million people per year, with a total estimated prevalence of 11-16 million people. Dramatic increases in the numbers of “oldest old” (aged 85 years and older) across all racial and ethnic groups will also significantly affect the numbers of people living with AD.

This report provides information to increase understanding of the public health effect of AD, including incidence and prevalence, mortality, costs of care, and effect on caregivers and society in general. This report also sets the stage for better understanding the relationship between race and ethnicity and the development of AD and other dementias.

Definition

AD is the most common cause of dementia. Dementia is characterized by the loss of or decline in memory and other cognitive abilities. It is caused by various diseases and conditions that result in damaged brain cells. To be classified as dementia, the following criteria must be met:

It must include decline in memory and decline in at least one of the following cognitive abilities:

(1)Ability to generate coherent speech or understand spoken or written language;

(4)Ability to think abstractly, make sound judgments, and plan and carry out complex tasks.

The decline in cognitive abilities must be severe enough to interfere with daily life.

Different types of dementia have been associated with distinct symptom patterns and distinguishing microscopic brain abnormalities. Increasing evidence from long-term epidemiological observation and autopsy studies suggests that many people have brain abnormalities associated with more than one type of dementia. The symptoms of different types of dementia also overlap and can be further complicated by coexisting medical conditions.

In AD, as in other types of dementia, increasing numbers of nerve cells deteriorate and die. A healthy adult brain has 100 billion nerve cells, or neurons, with long branching extensions connected at 100 trillion points. At these connections, called synapses, information flows in tiny chemical pulses released by one neuron and taken up by the receiving cell. Different strengths and patterns of signals move constantly through the brain’s circuits, creating the cellular basis of memories, thoughts, and skills.

In AD, information transfer at the synapses begins to fail, the number of synapses declines, and eventually cells die. Brains with advanced AD show dramatic shrinkage from cell loss and widespread debris from dead and dying neurons.

Symptoms of AD

AD can affect different people in different ways, but the most common symptom pattern begins with gradually worsening difficulty in remembering new information. This is because disruption of brain cells usually begins in regions involved in forming new memories. As damage spreads, individuals experience other difficulties. The following are warning signs of AD:

Memory loss that disrupts daily life.

Challenges in planning or solving problems.

Difficulty completing familiar tasks at home, at work, or at leisure.

Confusion with time or place.

Trouble understanding visual images and spatial relationships.

New problems with words in speaking or writing.

Misplacing things and losing the ability to retrace steps.

Decreased or poor judgment.

Withdrawal from work or social activities.

Changes in mood and personality.

In advanced AD, people need help with bathing, dressing, using the bathroom, eating, and other daily activities. Those in the final stages of the disease lose their ability to communicate, fail to recognize loved ones, and become bed-bound and reliant on 24/7 care. The inability to move around in late-stage AD can make a person more vulnerable to infections, including pneumonia (infection of the lungs). AD is ultimately fatal, and AD-related pneumonia is often the cause.

Although families generally prefer to keep the person with AD at home as long as possible, most people with the disease eventually move into a nursing home or another residence where professional care is available.

Risk factors for AD

Although the cause or causes of AD are not yet known, most experts agree that AD, like other common chronic conditions, probably develops as a result of multiple factors rather than a single cause.

The greatest risk factor for AD is advancing age, but AD is not a normal part of aging. Most Americans with AD are aged 65 or older, although individuals younger than age 65 can also develop the disease.

When AD or another dementia is recognized in a person under age 65, these conditions are referred to as “younger-onset” or “early-onset” AD or “younger-onset” or “early-onset” dementia.

A small percentage of AD cases, probably less than 1%, are caused by rare genetic variations found in a small number of families worldwide. These variations involve chromosome 21 on the gene for the amyloid precursor protein, chromosome 14 on the gene for the presenilin 1 protein, and chromosome 1 on the gene for presenilin 2. In these inherited forms of AD, the disease tends to develop before age 65, sometimes in individuals as young as 30 years.

A genetic factor in late-onset AD (AD developing at age 65 or older) is apolipoprotein E [4 (APOE [4). APOE [4 is one of the three common forms of the APOE gene, which provides the blueprint for a protein that carries cholesterol in the bloodstream. Everyone inherits one form of the APOE gene from each of his or her parents. Those who inherit one APOE [4 gene have increased risk of developing AD. Those who inherit two APOE [4 genes have an even higher risk. However, inheriting one or two copies of the gene does not guarantee that the individual will develop AD.

A significant portion of people with mild cognitive impairment (MCI), but not all, will later develop AD. MCI is a condition in which a person has problems with memory, language, or another essential cognitive function that are severe enough to be noticeable to others and show up on cognitive tests, but not severe enough to interfere with daily life. Studies indicate that as many as 10%-20% of people aged 65 and older have MCI. People whose MCI symptoms cause them enough concern to visit a physician appear to have a higher risk of developing dementia. It is estimated that as many as 15% of these individuals progress from MCI to dementia each year. From this estimate, nearly half of all people who have visited a physician about MCI symptoms will develop dementia in 3 or 4 years. It is unclear what mechanisms put those with MCI at greater risk for developing AD or other dementia. MCI may, in some cases, represent a transitional state between normal aging and the earliest symptoms of AD.

Treatment and prevention of AD

No treatment is available to slow or stop the deterioration of brain cells in AD. The U.S. Food and Drug Administration has approved five drugs that temporarily slow worsening of symptoms for about 6-12 months, on average, for about half of the individuals who take them. Researchers have identified treatment strategies that may have the potential to change its course. Approximately 90 experimental therapies aimed at slowing or stopping the progression of AD are in clinical testing in human volunteers.

Despite the current lack of disease-modifying therapies, studies have consistently shown that active medical management of AD and other dementias can significantly improve quality of life through all stages of the disease for diagnosed individuals and their caregivers. Active management includes appropriate use of available treatment options, effective integration of coexisting conditions into the treatment plan, coordination of care among physicians and others involved in maximizing quality of life for people with AD or other dementia, and use of supportive services such as counseling, activity and support groups, and adult day center programs.

A growing body of evidence suggests that the health of the brain – one of the body’s most vascular organs – is closely linked to the overall health of the heart and blood vessels. Some data indicate that management of cardiovascular risk factors, such as high cholesterol, Type 2 diabetes, high blood pressure, smoking, obesity and physical inactivity may help avoid or delay cognitive decline. Many of these risk factors are modifiable – that is, they can be changed to decrease the likelihood of developing both cardiovascular disease and the cognitive decline associated with AD and other forms of dementia. More limited data suggest that a low-fat diet rich in fruits and vegetables may support brain health, as may a robust social network and a lifetime of intellectual curiosity and mental stimulation.

Prevalence

Millions of Americans now have AD or other dementia. More women than men have dementia, primarily because women live longer, on average, than men. This longer life expectancy increases the time during which women could develop AD or other dementia.

Estimates from different studies on the prevalence and characteristics of people with AD and other dementias vary, depending on how each study was conducted. Data from several studies are used in this section to describe the prevalence of these conditions and the proportion of people with the conditions by gender and years of education. Data sources and study methods are described, and more detailed information is contained in the End Notes section in the Appendices.

Prevalence of AD and other dementias

An estimated 5.3 million Americans of all ages have AD. This figure includes 5.1 million people aged 65 and older [10] and 200,000 individuals under age 65 who have younger-onset AD. The Alzheimer’s Association estimates that there are 500,000 Americans younger than 65 with AD and other dementias. Of these, approximately 40% are estimated to have AD.

Prevalence of AD and other dementias in women and men

Women are more likely than men to have AD and other dementias. On the basis of estimates from the Aging, Demographics, and Memory Study (ADAMS), 14% of all people aged 71 and older have dementia. As shown in Fig. 1, women aged 71 and older had higher rates than men: 16% for women and 11% for men.

Estimated percentage of Americans aged 71+ with dementia. by gender, ADAMS, 2002. Created from data from Plassman et al

Further analysis of these data shows that the larger proportion of older women than men who have dementia is primarily explained by the fact that women live longer, on average, than men. Likewise, many studies of the age-specific incidence (new cases) of dementia have found no significant difference by gender.

A similar explanation is believed to be true for AD. The larger proportion of older women than men who have AD is believed to be explained by the fact that women live longer. Again, many studies of the age-specific incidence of AD show no significant difference for women and men. Thus, it appears that gender is not a risk factor for AD and other dementias when age is taken into account.

Prevalence of AD and other dementias by years of education

People with fewer years of education appear to be at higher risk for AD and other dementias than those with more years of education. Prevalence and incidence studies show that having fewer years of education is associated with a greater likelihood of having dementia and a greater risk of developing dementia.

Some researchers believe that having more years of education (compared with those with fewer years) provides a “cognitive reserve” that enables individuals to compensate for symptoms of AD or another dementia. However, others believe that these differences in education attainment and dementia risk reflect factors such as increased risks for disease in general and less access to medical care in lower socioeconomic groups.

Racial and ethnic differences in rates of AD and other dementias have also been reported and are more fully discussed in the Special Report.

Causes of dementia

Although AD is the most common form of dementia, data are emerging to suggest that the attribution of dementia to specific types may not be as clear-cut as previously believed. A study by Schneider et al reports that most older community-dwelling people (mean age at death, approximately 88 years) have changes in the brain suggestive of disease. People with dementia often have evidence of multiple types of brain disease.

Of the first 141 autopsies in this study, 80 examined brain tissue samples from people with intermediate or high likelihood of having AD based on clinical evaluation, which included medical history, neuropsychological tests, and physical examination, with an emphasis on neurologic function. Less than half of the 80 autopsies showed evidence of AD alone. Nearly a third showed evidence of AD and infarcts; 15% showed evidence of AD and Parkinson’s disease/Lewy body disease; 5% showed evidence of all three diseases; and 2.5% showed evidence of AD and a brain disease other than infarcts or Parkinson’s disease/Lewy body disease. Although 50% of participants with little or no likelihood of having AD based on clinical evaluation also had no evidence of dementia on autopsy, approximately one-third showed signs of brain infarcts. Thus, there is reason to believe that the causes of dementia may be much more complicated than originally believed.

Looking to the future

The number of Americans surviving into their 80s and 90s and beyond is expected to grow dramatically as a result of advances in medicine and medical technology, as well as social and environmental conditions. Because the incidence and prevalence of AD and other dementias increase with age, the number of people with these conditions will also grow rapidly.

In 2000, there were an estimated 411,000 new (incident) cases of AD. For 2010, that number is projected to be 454,000 new cases; by 2030, 615,000; and by 2050, 959,000.

This year, more than an estimated 5.5 million Americans are 85 years and older; by 2050, that number will nearly quadruple to 19 million.

Although the number of Americans aged 100 years and older is estimated at 80,000 in 2010, by 2050 there will be more than a half million Americans aged 100 years and older.

The 85-years-and-older population currently includes about 2.4 million people with AD, or 47% of the AD population aged 65 and older. When the first wave of baby boomers reaches age 85 years (2031), an estimated 3.5 million people aged 85 and older will have AD.

The number of people aged 65 and older with AD is estimated to reach 7.7 million in 2030 – more than a 50% increase from the 5.1 million aged 65 and older currently affected.

By 2050, the number of individuals aged 65 and older with AD is projected to number between 11 million and 16 million – unless medical breakthroughs identify ways to prevent or more effectively treat the disease. Barring such developments, by that date, more than 60% of people with AD will be aged 85 or older.

Mortality

AD was the seventh leading cause of death across all ages in the United States in 2006. It was the fifth leading cause of death for those aged 65 and older. In the final data for 2006, AD was reported as the underlying cause of death for 72,432 people. Of note are the nearly identical numbers of deaths attributed to diabetes (the sixth leading cause of death) and AD. In fact, the preliminary data for 2006 indicated AD was the sixth leading cause of death, and diabetes the seventh; only 17 deaths separated the sixth and seventh rankings.

The underreporting of AD as an underlying cause of death has been well documented, and it occurs in both local communities and in nursing homes. Death rates from the disease can vary a great deal across states, and result from differences in state demographics and reporting practices. Death rates among people with AD dramatically increase with age. From one community-based, 15-year prospective study, the mortality rate for people aged 75-84 years with AD was nearly 2.5 times greater than for those aged 55-74 with the disease. At age 85 and older, the rate was nearly twice that of those aged 75-84 with AD. Two-thirds of those dying of dementia did so in nursing homes, compared with 20% of cancer patients and 28% of people dying from all other conditions.

Deaths from AD

Although other major causes of death continue to experience significant declines, those for AD have continued to rise. In 1991, only 14,112 death certificates recorded AD as the underlying cause [39]. Comparing changes in selected causes of death between final data for 2000 and final data for 2006, deaths attributed to AD increased 46.1%, whereas those attributed to the number one cause of death, heart disease, decreased 11.1%. Patterns of reporting deaths on death certificates change substantially over time, however, for AD and for other causes of death. AD is a major cause of death and is clearly becoming a more common cause as the populations of the United States and other countries age. The increase in the number and proportion of death certificates listing AD may strongly reflect both changes in patterns of reporting deaths on death certificates as well as an increase in the actual number of deaths attributable to AD.

Race, ethnicity, and AD

Older African-Americans and Hispanics are considerably more likely than older whites to have AD and other dementias. Findings from different studies vary, but the available research indicates that older African-Americans are probably about 2 times more likely than older whites to have AD and other dementias. Older Hispanics are probably at least 1.5 times more likely than older whites to have these conditions.

When differences between racial and ethnic groups are found, it is sometimes assumed that the differences must be due to genetic factors, but no known genetic factors can account for the differences in the prevalence of AD and other dementias among older whites, African-Americans, and Hispanics. On the other hand, conditions such as high blood pressure and diabetes, both of which are known risk factors for AD and dementia, are more common in older African-Americans and Hispanics than in older whites and probably account for some of the differences in prevalence of AD and other dementias among these groups. Likewise, lower levels of education and other socioeconomic characteristics that are associated with increased risk for AD and other dementias are more common in older African-Americans and Hispanics than in older whites, and probably also account for some of the differences in prevalence among the groups.

This special report provides information about the prevalence of AD and other dementias by race and ethnicity, and the factors that are associated with and probably account for some of the differences in prevalence among whites, African-Americans, and Hispanics. The report also provides information about the extent to which AD and other dementias are diagnosed in different racial and ethnic groups, the proportion of older Medicare beneficiaries with AD and other dementias by race and ethnicity, and differences in the use and costs of medical services for older white, African-American, Hispanic, and other Medicare beneficiaries with these conditions.

To develop this report, the Alzheimer’s Association convened an Expert PanelA14 and reviewed findings from published studies. The Association also contracted for information from the 2006 Health and Retirement Study (HRS) survey, a large-scale survey of a nationally representative sample of older Americans, and obtained new Medicare data on the proportion of older Medicare beneficiaries with AD and other dementias by race and ethnicity and the use and costs of medical services in different racial and ethnic groups.

Ideally, information about the prevalence of AD and other dementias in different racial and ethnic groups would be based on studies that conducted a standardized diagnostic evaluation to identify people with these conditions and included a nationally representative sample large enough to allow for valid estimates of prevalence by race and ethnicity. The only such study completed to date is ADAMS, which provides information about the prevalence of AD and other dementias in whites and African-Americans aged 71 and older. Findings from ADAMS show that African-Americans aged 71 and older are almost 2 times more likely than whites in the same age group to have AD or other dementia (21.3% of African-Americans compared with 11.2% of whites).

To estimate the prevalence of AD and other dementias in white and African-American people aged < 71 years and Hispanics of any age, this report uses findings from other studies that conducted a standardized diagnostic evaluation to identify people with AD and other dementias and included a sample representative of the population of a given geographic area. The report uses findings from the HRS, which pertain to cognitive impairment rather than AD or dementia specifically, to provide a broad national context and foundation for thinking about the prevalence of cognitive impairment, AD, and other dementias in the United States, and about the health and socioeconomic factors that probably account for some of the differences in prevalence among racial and ethnic groups.

From 2010 to 2050, as the total number of Americans aged 65 and older increases from 40 million to 89 million, the proportion of older Americans in different racial and ethnic groups is expected to change markedly. In 2010, whites constitute about 80% of the U.S. population aged 65 and older, African-Americans about 9%, and Hispanics about 7%. Other racial and ethnic groups, including Asian-Americans, American Indians and Alaskan Natives, and Native Hawaiians and Pacific Islanders, constitute the remaining 4%. In 2050, it is expected that whites will constitute a smaller proportion of the older population (59%), African-Americans a larger proportion (12%), Hispanics a much larger proportion (20%), and other racial and groups the remaining 9%. Improved understanding about the prevalence of AD and other dementias in different racial and ethnic groups and the factors that are associated with and probably account for some of the differences in prevalence among these groups is essential for addressing the needs of people with these conditions and their families now and in the future.

]]>Parkinson’s Disease Dementiahttps://dementiatoday.net/parkinsons-disease-dementia/
Fri, 08 May 2020 23:56:07 +0000http://www.dementiatoday1.net/?p=4700Parkinson’s dementia is a condition that some people can experience as their Parkinson’s progresses. It a ects thinking and memory and can have a big impact on di erent aspects of life. This information sheet looks at the symptoms and […]

]]> Parkinson’s dementia is a condition that some people can experience as their Parkinson’s progresses. It a ects thinking and memory and can have a big impact on di erent aspects of life.

This information sheet looks at the symptoms and causes of Parkinson’s dementia and provides some practical advice on how life can be made easier for the person a ected and their family, friends and carers.

What is dementia?

Dementia symptoms are caused by a significant loss of brain function. There are diffierent forms of the condition and each person will experience dementia in their own way.

Some people will develop dementia after living with Parkinson’s for some time. When someone has Parkinson’s motor symptoms for at least a year before experiencing dementia, this is known as Parkinson’s dementia.

There is a similar condition called dementia with Lewy bodies. This is diagnosed when someone has the symptoms of dementia either before or at the same time as developing Parkinson’s-like problems with movement (called motor symptoms). In some cases, no motor symptoms may develop at all.

What are the symptoms of Parkinson’s dementia?

Symptoms can include forgetfulness, slow thought processes and difficulty concentrating. This can make communication hard and finding words and names or following conversations can be a problem.

Some people find it increasingly difficult to make decisions, plan activities and solve problems. This can make everyday activities such as dressing, cooking or cleaning increasingly hard.

People can also experience changes in their appetite, energy levels and sleeping patterns, so they may find themselves sleeping more during the day, or becoming less engaged with what’s going on around them. A lack of motivation or interest in things they previously enjoyed can also be a symptom.

Problems such as anxiety, depression or irritability can become an issue because of dementia. Some people may also find it difficult to control their emotions and experience sudden outbursts of anger or distress, although these problems are not common.

Some people with Parkinson’s dementia might also develop visual hallucinations and delusions.

Some of the symptoms of Parkinson’s dementia are similar to those caused by other health issues. For example, mental health issues such as depression can mimic dementia. Side effects from medication, or medical problems such as an infection may be the cause of symptoms similar to dementia, such as memory problems. Symptoms caused by medication or infections can be treated effectively.

It’s important to speak to your GP, specialist or Parkinson’s nurse (if you have one) if you think you have these symptoms. They will be able to give you advice on what to do next.

“Emotionally it is hard. Sometimes we have to repeat things and remind dad where he is, but reassurance helps him.” Jennifer, whose father has
Parkinson’s dementia

What causes Parkinson’s dementia?

We still don’t fully understand why some people with Parkinson’s get dementia and it isn’t entirely possible to predict who it will affect. But there are factors that put someone more at risk. Age, for example. It is rare that someone with Parkinson’s under the age of 65 will develop dementia.

If someone with Parkinson’s is experiencing hallucinations or delusions early on in their condition, this also suggests an increased risk of developing dementia.

If someone has been diagnosed with Parkinson’s later in life, has had Parkinson’s for a long period of time or has a family member with dementia, this can increase their risk of developing dementia.

How is Parkinson’s dementia diagnosed?

A specialist will diagnose this condition based on the patient’s symptoms, their medical history and the results of a medical examination. There is no specific blood test for this condition, but tests of memory and thinking will help confirm what the problem is.

The specialist may also talk to your spouse or family members to confirm the problems that issues such as memory difficulties are causing on a day-to-day basis.

It is important that other problems, such as severe depression, are excluded before the diagnosis of Parkinson’s dementia can be considered.

What can be done to help?

As with Parkinson’s, the symptoms of dementia can’t be cured, but they can be treated.

Reviewing your current medication
If someone with Parkinson’s has been diagnosed with dementia, the next step is for their specialist or Parkinson’s nurse to have a look at what medication they’re taking.

This is because some of the side effects of Parkinson’s medication can make the symptoms of dementia worse.

However, reducing the dose or withdrawing these drugs may mean that the Parkinson’s symptoms aren’t controlled as well as before.

For this reason, treating dementia often requires a compromise between managing the physical problems caused by Parkinson’s and managing the issues caused by dementia.

Dementia medications

Some people with Parkinson’s may be suitable for dementia medication. This is likely to depend on the stage of dementia and the person’s health. It may involve further memory and cognitive testing to see whether there is any change in symptoms over time.

These medications can’t cure or slow down the condition’s progress, but they can treat symptoms of dementia, such as hallucinations, delusions and confusion. Speak to your healthcare professional about taking these medications alongside your Parkinson’s medication.

Some people with Parkinson’s dementia can experience behavioural problems, such as sudden outbursts of anger. Medications called ‘antipsychotics’ or ‘neuroleptics’ might be considered to treat these symptoms. Specialists usually avoid prescribing neuroleptics, but in some cases, if behavioural symptoms are becoming especially problematic, very low doses of these medications may have to be used. If this medication is prescribed, the healthcare professionals in charge of a person’s care should monitor the situation carefully.

Any medication you take will need to be monitored.

It’s important to discuss the potential risks or side effects of any drug with your specialist so you can weigh these up against the problems you might have if you don’t take them.

If you have any questions about medication for Parkinson’s dementia, speak to your GP, specialist or Parkinson’s nurse for more advice and information.

Support from professionals

Medication can be helpful, but it’s also useful for people to get treatment from a wide range of healthcare professionals. People such as physiotherapists, occupational therapists, dietitians and speech and language therapists can help the person with dementia and those supporting them.

You can be referred to these health professionals through your GP, specialist or Parkinson’s nurse. In some areas, you might be able to refer yourself at the local hospital or community health clinic.

Legal matters

If you have been diagnosed with early stage dementia, you may want to make some important decisions about things like your finances or Will, and what sort of healthcare and social care you’d like in the future. You may also want to choose someone you trust to handle your affairs, and make this a legal agreement, such as a Power of Attorney. For more information and advice, you can contact the Office of the Public Guardian (England and Wales), the Office of Care and Protection (Northern Ireland) or the Office of the Public Guardian (Scotland). Contact details are listed on page 6 of this information sheet.

Caring for someone with dementia

If someone becomes less able because of their dementia, it may be necessary for their family or friends to start helping with things such as shopping, housework or cooking. If this is the case, the person may be able to apply for an Attendance Allowance or Disability Living Allowance, which will help provide some financial support.

Practical advice

If you are caring for someone with dementia, there are some practical things you can do that can help reduce their agitation or confusion and make life a bit easier:

Keep to a daily routine as much as you can to help them remember when certain things like meal times will happen.

Try to use familiar objects and phrases.

Avoid unfamiliar environments – these can be quite stressful.

Encourage someone with dementia to keep engaging and interacting with people. Hobbies are also a great way to keep memory and thinking as active as possible.

Helping with communication

Difficulties with communication can be upsetting and frustrating for the person with dementia and for those around them. But there are some basic things you can do to make life a little bit easier.

The following information has been provided by the Alzheimer’s Society.

General advice

Listen carefully to what a person with dementia says.

Make sure you have their full attention before you speak.

Pay attention to body language.

Speak clearly.

Consider whether any other factors are affecting their communication.

Use physical contact to reassure the person.

Show respect and keep in mind they have the same feelings and needs as they had before developing dementia.

Listening skills

Try to listen carefully to what they are saying, and give them plenty of encouragement.

If a person with dementia has difficulty finding the right word or finishing a sentence, ask them to explain in a different way. Listen out for clues.

If you find their speech hard to understand, use what you know about them to interpret what they might be trying to say. But always check back with them to see if you are right – it’s infuriating to have your sentence finished incorrectly by someone else.

If someone is feeling sad, let them express their feelings without trying to ‘jolly them along’.

Sometimes, the best thing to do is to just listen, and show that you care.

Attracting the person’s attention

Try to catch and hold their attention before you start to communicate.

Make sure they can see you clearly.

Make eye contact. This will help them focus on you.

Try to minimise competing noises, such as the radio, TV, or other people’s conversation.

Using body language

Someone with dementia will read your body language. Agitated movements or a tense facial expression may upset them, and can make communication more difficult.

Be calm and still while you communicate. This shows them that you are giving them your full attention, and that you have time for them.

Never stand over someone to communicate – it can feel intimidating. Instead, drop below their eye level. This will help them feel more in control of the situation.

Standing too close to someone can also feel intimidating, so always respect their personal space.

If someone is struggling to speak, pick up cues from their body language. The expression on their face, and the way they hold themselves and move about, can give you clear signals about how they are feeling.

Speaking clearly

As their dementia progresses, a person will become less able to start a conversation, so you may have to start taking the initiative.

Speak clearly and calmly. Avoid speaking sharply or raising your voice, as this may distress them even if they can’t follow the sense of your words.

Use simple, short sentences.

Processing information will take someone longer than it used to, so allow enough time. If you try to hurry them, they may feel pressured.

People with dementia can become frustrated if they can’t find the answer to questions, and they may respond with irritation or even aggression. If you have to, ask questions one at a time, and phrase them in a way that allows for a ‘yes’ or ‘no’ answer.

Try not to ask the person to make complicated decisions. Too many choices can be confusing and frustrating.

If the person doesn’t understand what you are saying, try getting the message across in a different way rather than simply repeating the same thing.

Humour can help to bring you closer together, and is a great pressure valve. Try to laugh together about misunderstandings and mistakes – it can help.

Whose reality?

As dementia progresses, fact and fantasy can become confused. If someone says something you know isn’t true, try to find ways around the situation rather than responding with a fat contradiction.

Always avoid making the person with dementia feel foolish in front of other people.

Physical contact

Even when conversation becomes more difficult, being warm or affectionate can help carers to remain close to their loved ones, or for the person with dementia to feel supported.

Communicate your care and affection by the tone of your voice and the touch of your hand.

Don’t underestimate the reassurance you can give by holding or patting their hand or putting your arm around them, if it feels right.

Show respect

Make sure no-one speaks down to the person with dementia or treats them like a child, even if they don’t seem to understand what people say. No one likes being patronised.

Try to include them in conversations with others. You may find this easier if you adapt the way you say things slightly. Being included in social groups can help a person with dementia to keep their sense of identity. It also helps to protect them from feeling excluded or isolated.

If you are getting little response from someone with dementia, it can be very tempting to speak about them as if they weren’t there. But disregarding them in this way can make them feel very cut off, frustrated and sad.

Other causes of communication difficulty

It is important to bear in mind that communication can be affected by other factors in addition to dementia – for example:

pain, discomfort, illness or the side-effects of medication. If you suspect this might be happening, talk to the person’s GP at once problems with sight, hearing or ill-fitting dentures. Make sure the person’s glasses are the correct prescription, that their hearing aids are working properly, and that their dentures fit well and are comfortable

Parkinson’s symptoms can cause difficulties with communication

Dr Iracema Leroi, Consultant Psychiatrist for the Elderly and Honorary Senior Lecturer with a special interest in mental health in Parkinson’s, University of Manchester

Professor Ian McKeith, Professor of Old Age Psychiatry, Institute for Ageing and Health, Newcastle University

]]>Vascular dementiahttps://dementiatoday.net/vascular-dementia/
Fri, 08 May 2020 23:53:23 +0000http://www.dementiatoday1.net/?p=4697Vascular dementia is one of the most common forms of dementia, ranking only second to Alzheimer’s disease. Vascular dementia is caused by chronic, reduced blood flow to the brain-usually as the result of a stroke or series of strokes. In […]

]]> Vascular dementia is one of the most common forms of dementia, ranking only second to Alzheimer’s disease. Vascular dementia is caused by chronic, reduced blood flow to the brain-usually as the result of a stroke or series of strokes. In many cases, the strokes are so small that you may not notice any symptoms. These are known as “silent strokes.” But over time, the damage adds up, leading to memory loss, confusion, and other signs of dementia.

Vascular dementia represents a challenge for those affected by it and their caretakers. But with an understanding of the condition, and a willingness to make important lifestyle changes, it may be possible to prevent further blockages and compensate for brain damage that has already occurred.

What is vascular dementia?

Vascular dementia refers to a subtle, progressive decline in memory and cognitive functioning. It occurs when the blood supply carrying oxygen and nutrients to the brain is interrupted by a blocked or diseased vascular system. If blood supply is blocked for longer than a few seconds, brain cells can die, causing damage to the cortex of the brain-the area associated with learning, memory, and language.

Depending on the person, and the severity of the stroke or strokes, vascular dementia may come on gradually or suddenly. Currently, there is no known cure, but the good news is that making certain lifestyle changes and using practical strategies may help prevent strokes, compensate for cognitive loses, and slow its development.

Factors that increase your risk of heart disease and stroke – including high blood pressure, high cholesterol and smoking – also raise your vascular dementia risk. Controlling these factors can help lower your chances of developing vascular dementia.

Multi-infarct dementia: The most common type of vascular dementia

The most common type of vascular dementia is multi-infarct dementia (MID), which is caused by a series of small strokes, or “mini-strokes,” that often go unnoticed and cause. These mini-strokes, also referred to as transient ischemic attacks (TIAs), result in only temporary, partial blockages of blood supply and brief impairments in consciousness or sight. Over time, however, as more areas of the brain become damaged, the symptoms of vascular dementia begin to appear.

Signs and symptoms of vascular dementia

Vascular dementia affects different people in different ways and the speed of the progression varies from person to person. Some symptoms may be similar to those of other types of dementia and usually reflect increasing difficulty to perform everyday activities like eating, dressing, or shopping.

Behavioral and physical symptoms can come on dramatically or very gradually, although it appears that a prolonged period of TIAs-the mini-strokes discussed above-leads to a gradual decline in memory, whereas a bigger stroke can produce profound symptoms immediately. Regardless of the rate of appearance, vascular dementia typically progresses in a stepwise fashion, where lapses in memory and reasoning abilities are followed by periods of stability, only to give way to further decline.

Vascular dementia symptoms vary, depending on the part of your brain where blood flow is impaired. Symptoms often overlap with those of other types of dementia, especially Alzheimer’s disease. Vascular dementia symptoms may be most clear-cut when they occur suddenly following a stroke. When changes in your thinking and reasoning seem clearly linked to a stroke, this condition is sometimes called “post-stroke dementia.”

Another characteristic pattern of vascular dementia symptoms sometimes follows a series of strokes or mini strokes. In this pattern, changes in your thought processes occur in noticeable “steps” downward from your previous level of function, unlike the gradual, steady decline that typically occurs in Alzheimer’s disease.

But vascular dementia can also develop very gradually, just like Alzheimer’s disease. What’s more, vascular dementia and Alzheimer’s often occur together. Studies show that people with dementia symptoms usually have brain changes typical of more than one type. Some doctors call this condition “mixed dementia.”

Common mental and emotional signs and symptoms of vascular dementia

Slowed thinking

Memory problems; general forgetfulness

Unusual mood changes (e.g. depression, irritability)

Trouble paying attention and concentrating

Decline in ability to analyze a situation, develop an effective plan, and communicate plan to others

Hallucinations and delusions

Confusion, which may get worse at night.

Personality changes and loss of social skills

Reduced ability to organize thoughts or actions

Common physical signs and symptoms of vascular dementia

Dizziness

Leg or arm weakness

Tremors

Wandering at night

Moving with rapid, shuffling steps

Balance problems

Loss of bladder or bowel control

Common behavioral signs and symptoms of vascular dementia

Slurred speech

Language problems, such as difficulty finding the right words for things

Getting lost in familiar surroundings

Laughing or crying inappropriately

Difficulty planning, organizing, or following instructions

Difficulty doing things that used to come easily (e.g. paying bills or playing a favorite card game)

Reduced ability to function in daily life

Causes of vascular dementia

Stroke, small vessel disease, or a mixture of the two can cause vascular dementia. Most commonly there is a blockage of small blood vessels somewhere in the vast system of arteries that feeds the brain and enters through the base of the skull. Blockages may be caused by plaque build up on the inside of the artery wall, or by blood clots which have broken loose and clogged a tributary further downstream. Clots can form as a result of abnormal heart rhythms, or other heart abnormalities. Also, a weak patch on an artery wall can balloon outward and form an aneurysm, which can burst and deprive the brain cells of oxygen.

It is estimated that about 50 percent of the cases of vascular dementia result from hypertension, or high blood pressure. Less common causes of vascular dementia are associated with autoimmune inflammatory diseases of the arteries such as lupus and temporal arteritis, which are treatable with drugs that suppress the immune system.

Call 911 immediately if you experience any of the following symptoms, which may indicate you’ve had a stroke or a transient ischemic attack (TIA), or mini-stroke.

Common conditions that may lead to vascular dementia include:

* Stroke (infarction) blocking a brain artery. Strokes that block a brain artery usually cause a range of symptoms that may include vascular dementia. But some strokes don’t cause any noticeable symptoms. These “silent brain infarctions” still increase dementia risk. With both silent and apparent strokes, the risk of vascular dementia increases with the number of infarctions that occur over time. One type of vascular dementia involving many strokes is called multi-infarct dementia.

* Narrowed or chronically damaged brain blood vessels. Conditions that narrow or inflict long-term damage on your brain blood vessels can also lead to vascular dementia. These conditions include the wear and tear associated with aging; high blood pressure; hardening of the arteries; diabetes; lupus erythematosus; brain hemorrhage; and temporal arteritis.

Risk factors

Certain factors can increase a person’s risk of developing dementia. These include:

In general, the risk factors for vascular dementia are the same as those for heart disease and stroke.

Risk factors for vascular dementia include:

Increasing age. Your risk for vascular dementia rises as you grow older. The disorder is rare before age 65, and risk rises substantially as you reach your 80s and 90s.

History of heart attack, strokes or mini strokes. If you’ve had a heart attack, you may be at increased risk of having blood vessel problems in your brain. The brain damage that occurs with a stroke or a mini stroke (transient ischemic attack) may increase your risk of developing dementia.

Atherosclerosis. This condition occurs when deposits of cholesterol and other substances (plaques) build up in your arteries and narrow your blood vessels. Atherosclerosis can increase your risk of vascular dementia – and possibly your risk of Alzheimer’s disease – by reducing the flow of blood that nourishes your brain.

High cholesterol. Elevated levels of low-density lipoprotein (LDL), the so-called “bad” cholesterol, are associated with an increased risk of vascular dementia, and possibly with a higher risk of Alzheimer’s disease.

High blood pressure. When your blood pressure’s too high, it puts extra stress on blood vessels everywhere in your body, including your brain. This increases the risk of vascular problems in the brain.

Atrial fibrillation. In this abnormal heart rhythm, the upper chambers of your heart begin to beat rapidly and irregularly, out of coordination with your heart’s lower chambers. Atrial fibrillation increases your risk of stroke by leading to poor blood flow to your brain and elsewhere in your body.

Different types of vascular dementia

There are two main types of vascular dementia: one caused by stroke and one caused by small vessel disease. A third type is a mixture of the two. There are many other types of vascular dementia.

Stroke-related dementia

Stroke is the term used to describe permanent brain damage caused by an interruption in the supply of blood to specific parts of the brain. The symptoms that a person experiences as a result of a stroke depend on which area of the brain has been damaged. If the area in question is responsible for movement of a limb, paralysis might occur. If it is responsible for speech, the person might have problems communicating. Equally, damage to particular areas in the brain can cause the symptoms of dementia.

When vascular dementia is caused by a single stroke, it is sometimes called single-infarct dementia. Vascular dementia can also be caused by a series of small strokes. These can be so tiny that the person might not notice any symptoms, or the symptoms may be only temporary. This is called multi-infarct dementia.

Always consult a doctor if you experience any sudden symptoms, such as slurred speech, weakness on one side of the body, or blurred vision – even if they are only temporary. These episodes may be caused by temporary interruptions in the blood supply within the brain, known as transient ischaemic attacks. If left untreated, they can lead to permanent damage.

Small vessel disease-related dementia

This type of dementia, also known as sub-cortical vascular dementia or, in a severe form, Binswanger’s disease, is caused by damage to tiny blood vessels that lie deep in the brain. The symptoms develop more gradually and are often accompanied by walking problems.

Vascular dementia and Alzheimer’s disease (mixed dementia)

A diagnosis of mixed dementia means that Alzheimer’s disease, as well as stroke or small vessel disease, may have caused damage to the brain.

Treatment

Controlling underlying conditions and risk factors
Controlling conditions that affect the underlying health of your heart and blood vessels can sometimes slow the rate at which vascular dementia gets worse, and may also sometimes prevent further decline. Depending on your individual situation, your doctor may prescribe medications to:

Lower your blood pressure

Reduce your cholesterol level

Prevent your blood from clotting and keep your arteries clear

Help control your blood sugar if you have diabetes

Alzheimer’s medications

The Food and Drug Administration (FDA) has not approved any drugs specifically to treat changes in judgment, planning, memory and other thought processes caused by vascular dementia. However, certain medications approved by the FDA to treat these symptoms in Alzheimer’s disease may also help people with vascular dementia to the same modest extent they help those with Alzheimer’s.

Doctors may prescribe one or both types of the following Alzheimer’s drugs:

Cholinesterase inhibitors – including donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon) – work by boosting levels of a brain cell chemical messenger involved in memory and judgment. Side effects can include nausea, vomiting, muscle cramps and diarrhea.

Memantine (Namenda) regulates another brain cell chemical messenger important for information processing, storage and retrieval. Side effects can include headache, constipation, confusion and dizziness.

Prevention

The health of your brain’s blood vessels is closely linked to your overall heart health. Taking these steps to keep your heart healthy may also help reduce your risk of vascular dementia:

Maintain a healthy blood pressure. Keeping your blood pressure in the normal range may help prevent both vascular dementia and Alzheimer’s disease.

Keep your cholesterol in check. A healthy, low-fat diet and cholesterol-lowering medications if you need them may reduce your risk of vascular dementia, probably by reducing the amount of plaque deposits building up inside your brain’s arteries.

Prevent or control diabetes. Avoiding the onset of diabetes, with diet and exercise, is another possible way to decrease your risk of dementia. If you already have diabetes, controlling your glucose levels can help protect your brain blood vessels from damage.

]]>Lewy body dementiahttps://dementiatoday.net/lewy-body-dementia/
Fri, 08 May 2020 23:50:24 +0000http://www.dementiatoday1.net/?p=4694Definition Lewy body dementia, the second most common type of progressive dementia after Alzheimer’s disease, causes a progressive decline in mental abilities. It may also cause visual hallucinations, which may take the form of seeing shapes, colors, people or animals […]

Definition

Lewy body dementia, the second most common type of progressive dementia after Alzheimer’s disease, causes a progressive decline in mental abilities. It may also cause visual hallucinations, which may take the form of seeing shapes, colors, people or animals that aren’t there or, more complexly, having conversations with deceased loved ones.

Another indicator of Lewy body dementia may be significant fluctuations in alertness and attention, which may include daytime drowsiness or periods of staring into space. And, like Parkinson’s disease, Lewy body dementia can result in rigid muscles, slowed movement and tremors.

What are Lewy bodies?

Lewy bodies, named after the doctor who first identified them in 1912, are tiny, spherical protein deposits found in nerve cells. Their presence in the brain disrupts the brain’s normal functioning, interrupting the action of important chemical messengers, including acetylcholine and dopamine. Researchers have yet to understand fully why Lewy bodies occur in the brain and how they cause damage.

Lewy bodies are also found in the brains of people with Parkinson’s disease, a progressive neurological disease that affects movement. Many people who are initially diagnosed with Parkinson’s disease later go on to develop a dementia that closely resembles DLB.

Symptoms

Lewy body dementia signs and symptoms may include:

Visual hallucinations. Seeing colors, shapes, animals or people that aren’t there may be one of the first symptoms of Lewy body dementia.

Complications

Preparing for your appointment

You’ll probably first bring your symptoms to the attention of your family doctor, who may refer you to a dementia specialist – usually a neurologist or a psychiatrist.

What you can do

To make the best of the time you have with your doctor, plan ahead and write lists of important information, including:

Detailed descriptions of all your symptoms

All your medications and dosages, including nonprescription drugs and supplements

Questions for the doctor, such as what tests or treatments he or she may recommend

You might also want to bring a family member or close friend who can tell the doctor about symptoms you might not have noticed.

What to expect from your doctorYou and your spouse, partner or someone else who knows you well may be asked about:

Changes in your memory, personality and behavior

Visual hallucinations

Medications you’re taking

Your history of stroke, depression, alcohol abuse, head trauma or other neurological disorders

Tests and diagnosis

For the doctor to make a diagnosis of Lewy body dementia, you must have experienced a progressive decline in your ability to think, as well as two of the following:

Fluctuating alertness and cognition

Repeated visual hallucinations

Parkinson’s-like symptoms

No single test can diagnose Lewy body dementia. Instead, doctors diagnose the disease through a process of elimination – ruling out other diseases and conditions that may cause similar signs and symptoms. Tests may include:

Neurological examAs part of your physical exam, your doctor may also check for signs of Parkinson’s disease, strokes, tumors or other medical conditions that can impair brain function as well as physical function. The neurological exam may test:

Reflexes

Eye movements

Balance

Sense of touch

Assessment of mental abilitiesA short form of this type of test, which assesses your memory and thinking skills, can be done in less than 10 minutes in your doctor’s office. Longer forms of neuropsychological testing can take several hours. Your results are then compared with those of people from a similar age and education level. This can help distinguish normal from abnormal cognitive aging, and may help identify patterns in cognitive functions that provide clues to the underlying condition.

Lab testsSimple blood tests can rule out physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland.

Electroencephalogram (EEG)If your confusion comes and goes, your doctor may suggest an EEG. This test can help determine if your symptoms are better explained by seizures or Creutzfeldt-Jakob disease, a rare, degenerative brain disorder that leads to dementia. This painless test records the electrical activity in your brain via wires attached to your scalp.

Brain scansYour doctor may order an MRI or CT scan to check for evidence of stroke or bleeding, and to rule out the possibility of a tumor.

Treatments and drugs

Treatment can be challenging, and there’s no cure for Lewy body dementia. Instead, doctors treat the individual symptoms.

Medications

Cholinesterase inhibitors. These Alzheimer’s disease medications work by increasing the levels of neurotransmitters – chemical messengers believed to be important for memory, thought and judgment – in the brain. This can help improve alertness and cognition, and may help reduce hallucinations and other behavioral problems. Possible side effects may include gastrointestinal upset, excessive salivation and tearing and frequent urination.

Parkinson’s disease medications. These medications can help reduce Parkinson’s-like muscular symptoms in some people with Lewy body dementia, but they can also cause increased confusion, hallucinations and delusions.

Antipsychotic medications. These medications may somewhat improve delusions and hallucinations. However, at least a third of the people who have Lewy body dementia have a dangerous sensitivity to some of these types of drugs. Reactions, which are sometimes irreversible, can include severe Parkinson’s-like symptoms and a worsening of confusion.

TherapiesBecause antipsychotic drugs can worsen the symptoms of Lewy body dementia, it might be better to initially try nondrug approaches, such as:

Modifying the environment. Reducing clutter and distracting noise can make it easier for someone with dementia to focus and function.

Modifying your responses. A caregiver’s response to a behavior can make the behavior worse. It’s best to avoid correcting and quizzing a person with dementia. Reassuring the person and validating his or her concerns can defuse most situations.

Modifying tasks. Break tasks into easier steps and focus on success, not failure. Structure and routine also help people with dementia feel safe.

How is dementia with Lewy bodies treated?

At present, there is no cure for dementia with Lewy bodies. Symptoms such as hallucinations may diminish if challenged, but it can be unhelpful to try to convince the person that there is nothing there. It is sometimes better to try to provide reassurance and alternative distractions. For more information, see Factsheet 520, Hallucinations in people with dementia.

Recent research suggests that the cholinesterase inhibitor drugs used to treat Alzheimer’s disease may also be useful in treating DLB, although they are not yet licensed for this use. However, recent guidelines from the National Institute of Clinical Excellence (NICE) do suggest that these drugs should be considered for ‘people with DLB who have non-cognitive symptoms causing significant distress to the individual, or leading to behaviour that challenges’.

A recent study also found the drug memantine (Ebixa) to improve general function in DLB although further studies are required to confirm this.

People who are experiencing symptoms such as rigidity and stiffness due to parkinsonism may benefit from anti-Parkinson’s disease drugs, although these can make hallucinations and confusion worse. Physiotherapy and mobility aids may also help alleviate these problems.

Dementia with Lewy bodies and neuroleptics

Neuroleptics are strong tranquillisers usually given to people with severe mental health problems. In the past, they have frequently been prescribed to people with dementia. However, it is always preferable to find ways of dealing with a person’s distress and disturbance that do not involve medication. Under no circumstances should neuroleptics be prescribed as a substitute for good quality care.

For people with dementia with Lewy bodies, neuroleptics may be particularly dangerous. This class of drugs induce Parkinson-like side-effects, including rigidity, immobility, and an inability to perform tasks or to communicate. Studies have shown that they may even cause sudden death in people with DLB. If a person with DLB must be prescribed a neuroleptic, this should be done with the utmost care, under constant supervision, and should be monitored regularly.

The names of many of the major neuroleptics available are listed below. New drugs are appearing from time to time. The generic name is given first, followed by some of the common proprietary (drug company) names for that particular compound: aripiprazole (Abilify), chlorpromazine (Largactil), clopenthixol (Clopixol), haloperidol (Haldol, Serenace), olanzapine (Zyprexa), promazine quetiapine (Seroquel), risperidone (Risperdal), sulpiride (Dolmatil, Sulparex, Sulpitil), trifluoperazine (Stelazine).

When caring for someone with dementia with Lewy bodies, it is important to be as flexible as possible, bearing in mind that the symptoms of DLB will fluctuate.

Lifestyle and home remedies

Each person with dementia experiences symptoms and progression differently. Consequently, techniques to care for each person vary. Caregivers may need to adapt the following tips to individual situations:

Enhance communication. When talking with your loved one, stand where you can be seen and touch his or her arm or shoulder to focus attention. Speak slowly, in simple sentences and don’t rush the response. Present only one idea or instruction at a time. Use gestures and cues, such as pointing to objects.

Encourage exercise. Exercise benefits everyone, including people with dementia. The main benefits of exercise include improved strength and cardiovascular health. Exercise can also lessen symptoms of depression, help retain motor skills and create a calming effect. It can also help sustain strength, flexibility and balance – which may lessen the risk of serious injury from a fall.

Establish a nighttime ritual. Behavior is often worse at night. Try to establish going-to-bed rituals that are calming and away from the noise of television, meal cleanup and active family members. Leave night lights on to prevent disorientation. Limiting caffeine during the day, discouraging daytime napping and offering opportunities for exercise during the day may help prevent nighttime restlessness.

Alternative medicine

People with dementia often experience a worsening of their symptoms when they are frustrated or anxious. The following techniques may help promote relaxation.

Music therapy, which involves listening to soothing music

Aromatherapy, which uses fragrant plant oils

Massage therapy

Coping and support

People with Lewy body dementia often experience a mixture of emotions – confusion, frustration, anger, fear, uncertainty, grief and depression.

You can help a person cope with the disease by listening, reassuring the person that he or she still can enjoy life, providing unconditional love and doing your best to help the person retain dignity and self-respect.

Caregivers must watch closely to make sure the person with Lewy body dementia doesn’t fall or lose consciousness or react badly to medications, and they must reassure that person during times of delusions or hallucinations.

Looking after yourselfThe physical and emotional demands of caregiving can be exhausting. Feelings of anger and guilt, frustration and discouragement, worry and grief, and social isolation are common. If you’re a caregiver for someone with this disease, you can help yourself and help prevent caregiver burnout by doing the following:

Ask friends or other family members for help when you need it.

Take care of your health.

Learn as much about the disease as you can. Ask questions of doctors, social workers and others involved in the care of your loved one.

Join a support group.

Many people with Lewy body dementia and their families can benefit from counseling or local support groups. Contact your local agencies on health or aging to get connected with support groups, doctors, resources and referrals, home care agencies, supervised living facilities, a telephone help line and educational seminars.

]]>New link found between diabetes and Alzheimer’s diseasehttps://dementiatoday.net/new-link-found-between-diabetes-and-alzheimers-disease/
Wed, 22 Jun 2016 05:03:36 +0000http://www-2b36z.hosts.cx/?p=667Drugs used to treat diabetes could also be used to treat Alzheimer’s disease, and vice versa, according to new research from the University of Aberdeen. This is also the first study of its kind to show that Alzheimer’s disease can […]

]]>Drugs used to treat diabetes could also be used to treat Alzheimer’s disease, and vice versa, according to new research from the University of Aberdeen.

This is also the first study of its kind to show that Alzheimer’s disease can lead to diabetes, as opposed to diabetes occurring first as was previously thought.

The study reports that Alzheimer’s Disease and type 2 diabetes are so closely related that drugs currently used to control glucose levels in diabetes may also alleviate the symptoms and progression of Alzheimer’s disease.

The paper, published in the journal Diabetologia (the journal of the European Association for the Study of Diabetes), found for the first time that dementia-related complications within the brain can also lead to changes in glucose handling and ultimately diabetes. This is contrary to what was previously thought – that diabetes begins with a malfunction in the pancreas or a high fat, high sugar diet.

The research was led by Professor Bettina Platt who formed a unique collaboration between her Alzheimer’s research team and the diabetes research team led by Professor Mirela Delibegovic. The teams were keen to investigate why the two diseases are so commonly found together in elderly patients.

The researchers developed a model of Alzheimer’s disease and were surprised to find that increased levels of a gene involved in the production of toxic proteins in the brain not only led to Alzheimer’s -like symptoms, but also to the development of diabetic complications.

Professor Platt said of her research: “Many people are unaware of the relationship between diabetes and Alzheimer’s disease, but the fact is that around 80% of people with Alzheimer’s disease also have some form of diabetes or disturbed glucose metabolism. This is hugely relevant as Alzheimer’s is in the vast majority of cases not inherited, and lifestyle factors and comorbidities must therefore be to blame.

“Our research teams are particularly interested in the impact of lifestyle related factors in dementia and by collaborating with experts in diabetes and metabolism, we have been able to investigate the nature of the link in great detail.

“Until now, we always assumed that obese people get type 2 diabetes and then are more likely to get dementia – we now show that actually it also works the other way around.

“Additionally, it was previously believed that diabetes starts in the periphery, i.e. the pancreas and liver, often due to consumption of an unhealthy diet, but here we show that dysregulation in the brain can equally lead to development of very severe diabetes – so again showing that diabetes doesn’t necessarily have to start with your body getting fat – it can start with changes in the brain.

“This study provides a new therapeutic angle into Alzheimer’s disease and we now think that some of the compounds that are used for obesity and diabetic deregulation might potentially be beneficial for Alzheimer’s patients as well. The good news is that there are a number of new drugs available right now which we are testing to see if they would reverse both Alzheimer’s and diabetes symptoms. We will also be able to study whether new treatments developed for Alzheimer’s can improve both, the diabetic and cognitive symptoms.”

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Dr. Wendy Skene.(JavaScript must be enabled to view this email address)
44-122-427-3174
Diabetologia